The frailty syndrome: definition and natural history.

Department of Medicine, Johns Hopkins University School of Medicine, 2024 East Monument Street, Suite 2-700, Baltimore, MD 21205-1179, USA.
Clinics in Geriatric Medicine (Impact Factor: 3.19). 02/2011; 27(1):1-15. DOI: 10.1016/j.cger.2010.08.009
Source: PubMed

ABSTRACT This article reviews the current state of knowledge regarding the epidemiology of frailty by focusing on 6 specific areas: (1) clinical definitions of frailty, (2) evidence of frailty as a medical syndrome, (3) prevalence and incidence of frailty by age, gender, race, and ethnicity, (4) transitions between discrete frailty states, (5) natural history of manifestations of frailty criteria, and (6) behavior modifications as precursors to the development of clinical frailty.

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    ABSTRACT: Over the last decade, the scientific advances in health care have increased the life expectancy of the world population. Although the number of research in this area has increased, there are still some question marks about the frailty in the elderly to be addressed. The objective of this work is to develop a biomedical instrumentation to measure and to assess the muscle strength by force measurements. In order to obtain the force curve, both handgrip strength and the quadriceps muscle strength are analyzed in the Maximum Voluntary Isometric Contraction (MVIC) from dominant body side. Muscle strength is measured by one load cell coupled into a home-made device. The signal is conditioned by a microcontroller and connected to a computer system for data visualization and storage. Both handgrip and quadriceps muscle strength are analyzed from two healthy volunteers. Preliminary results of this pilot study indicate that the developed device meets the objectives of this work and that it can be used to enhance the assessment in the elderly with the frailty syndrome.
    VI Latin American Congress on Biomedical Engineering, Paraná (Argentina); 10/2014
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    ABSTRACT: Nearly 50% of Americans will have an operation after the age of 65 years. Traditional preoperative anesthesia consultations capture only some of the information needed to identify older patients (defined as ≥65 years of age) undergoing elective surgery who are at increased risk for postoperative complications, prolonged hospital stays, and delayed or hampered functional recovery. As a catalyst to this review, we compared traditional risk scores (eg, cardiac-focused) to geriatric-specific risk measures from two older female patients seen in our preoperative clinic who were scheduled for elective, robotic-assisted hysterectomies. Despite having a lower cardiac risk index and Charlson comorbidity score, the younger of the two patients presented with more subtle negative geriatric-specific risk predictors - including intermediate or pre-frail status, borderline malnutrition, and reduced functional/mobility - which may have contributed to her 1-day-longer length of stay and need for readmission. Adequate screening of physiologic and cognitive reserves in older patients scheduled for surgery could identify at-risk, vulnerable elders and enable proactive perioperative management strategies (eg, strength, balance, and mobility prehabilitation) to reduce adverse postoperative outcomes and readmissions. Here, we describe our initial two cases and review the stress response to surgery and the impact of advanced age on this response as well as preoperative geriatric assessments, including frailty, nutrition, physical function, cognition, and mood state tests that may better predict postoperative outcomes in older adults. A brief overview of the literature on anesthetic techniques that may influence geriatric-related syndromes is also presented.
    Clinical Interventions in Aging 01/2015; 10:13-27. · 2.65 Impact Factor
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    Revista Brasileira de Cineantropometria e Desempenho Humano. 04/2014; 16(3):359.


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